FtM Chest Surgery Diary - Eight Weeks On

On the 4th December 2014, I had my chest surgery (sometimes called top surgery) at long last, with surgeon Catherine Milroy at St George's Hospital in London. This procedure served to change my previously female-appearing chest into a male-appearing chest as part of the process of gender affirmation/reassignment I've been going through over the past few years. For me, this has been truly life-changing already, because as I outlined in this previous post, having breasts caused me a great deal of distress as a transsexual man and created practical difficulties due to the need to bind them and through them causing me to be misread as a female.

 

In the hope of being helpful to others contemplating having chest surgery, I thought it may be useful to document the process as I go through recovery and adapt to my changed body.

 

The procedure I've had done is called a bilateral mastectomy with a nipple graft, meaning that the breast tissue that blighted my chest has been removed, a male-appearing chest has been crafted, and my nipples have been cut down to size and placed in the right part of my chest. I had to go down this route because my chest was quite substantial (DD cups - God has a sense of humour!), but smaller guys can have a keyhole procedure more akin to liposuction. This has the consequence that, as the photo below shows, I have scars around where my pectoral muscles lie which will fade with time but never entirely disappear. However, it does mean that I can now feel comfortable when I look in the mirror for the first time since I hit puberty, and can wear whatever I like without worrying about how visible my breasts are, both of which are awesome!

Eight weeks after chest surgery

In preparation for the surgery, I lost two-and-a-half stone so that my risk of an adverse reaction to the general anaesthetic would be reduced and to try to ensure a smoother recovery. Things didn't quite work out like that, as I got an infection in my left nipple and needed antibiotics to sort it out. I'm told it won't look as good as the right one, in that it won't have the pigment in it that it should, but it will discernibly be a nipple! I was initially worried that it would be permanently disfigured. However, despite this setback, I think the exercise and weight loss was very definitely worth it, as I bounced back quickly and my scars have healed very well and effectively.

The whole procedure meant spending a total of three days in hospital; this is something that a trawl of the internet suggests varies from surgeon to surgeon. Immediately after, it didn't hurt anywhere near as much as I'd worried it might, because my only previous experience was breaking my leg, and that was absolute agony when I came around. In the following days, I had to wait for the drains they'd put in to suck out the blood remaining around the wounds, so I wouldn't get swelling or an infection. Carrying them around everywhere with me was a bit odd, and they did hurt somewhat and restricted my movement; taking them out was the only really painful - as in enough to make me scream - part of the whole thing, though. Afterwards, I could move much more freely and felt a lot more comfortable.

Upon getting home, I began the slow process of recovering and getting back to normal. I'd been told that while I needed to go for walks, keep moving and do as much as possible, I couldn't lift more than a couple of kilos for a fortnight and therefore needed help with some tasks. I couldn't do things like housework or cooking, and not being able to reach too high meant Sally had to prepare things for me and put out plates and such like for me to use. However, I did find that, quite quickly, I could do a good range of normal things and that my chest would soon let me know if I was overdoing it! It was useful for Sally to be about to give me a bit of reassurance taking a shower, for example, but it wasn't long before I could do that myself without worry.

After four weeks, I was able to stop dressing my scars and nipples (it took me a while to get the hang of doing this myself and to build my confidence), and now have to massage my scars with fragrance-free moisturiser for ten minutes twice a day. They don't hurt, and indeed haven't very much since I left hospital - I stopped painkillers once free from infection, and even then I was relying on them more to stop me getting feverish than for pain management. Six weeks after my operation, I stopped wearing the compression vest that I was told to wear twenty-four hours a day. This was a relief, as I needed to sleep on my back and even with the special pillow Sally bought me, it became very painful. Trying to sleep on my side pulled on the parts of my scars reaching around to my armpits, and while they're now fine, it was very uncomfortable at the time. The vest also caused tingling sensations in my scars, which weren't very pleasant, but wearing it resulted in a better shape than would've otherwise emerged and preventing swelling.

So now life is getting back to normal, eight weeks on, and I can manage getting to and from work and going about the tasks of daily life without problem. I've got used to the feeling of clothes against my chest; I didn't have the panic about not binding some guys have described, but it was very odd not needing to tuck clothes under my breasts to prevent chaffing! Reprogramming my brain to not worry about covering my chest or being seen topless has taken time, but I think I've got there. Being able to wear whatever I like and not worry about how my chest looks has been liberating, but the expense of needing to get clothes taken in or replaced due to the big drop in my chest size wasn't something I'd factored in beforehand. Suiting is the hardest thing to adapt, and I've got rid of four large bags of clothes, including my favourite blazer. I can now wear smaller stuff, but will need to get rid of my belly to get into stuff that ideally fits around the chest.

Hopefully this gives an honest flavour of what it's like to have this operation and go through the process of getting back on one's feet. I have absolutely no regrets, and having been through three psychological assessments and nine months of physical preparation to be able to do this, am relieved to finally have gotten to this point. I can now get on with my life as a confident and happy young man who no longer has to pretend to be something I'm not, and who can now put the energy that was going into repressing the truth into making the most of things and looking to serve others. The healing that's occurred over the last few years means, I think, that I'm better able to love God and others, and that can only be a good thing.